Aims and rationale:  In 2011, the Northwest Adelaide Health Survey demonstrated that the community prevalence of diabetes was 7.4%, with an increased prevalence amongst patients with cardiovascular disease. Studies in patients presenting with acute coronary syndromes (ACS) have suggested an incidence as high as 50% of newly diagnosed impaired glucose metabolism.

To fully assess the cardiovascular risk of patients being admitted for suspected ACS at the Lyell McEwin Hospital, a diabetes screening program has been conducted since 2008. Patients enrolled in the program have their glycated haemoglobin (HbA1c) level performed on admission to hospital if it has not been performed in the preceding three months. This result is then communicated to each patient’s general practitioner with management advice following patient discharge. This study aimed to assess adherence to hospital screening protocol and to determine the proportion of these patients who were newly diagnosed with abnormal glucose metabolism or diabetes mellitus.

Methods: A retrospective review of electronic medical records of cardiology inpatients in the last six months of 2013 was conducted. A random number generator was used to select the sample population. In patients unknown to have diabetes, abnormal glucose metabolism was defined as HbA1c 5.7-6.4% and new diabetes as HbA1c ≥6.5%.

Findings: Ninety-nine patient records were reviewed of which sixty-six had HbA1c recorded during their admission or within the preceding three months, suggesting that screening adherence was approximately 66.7%. Nineteen (28.8%) of these sixty-six patients were known to have pre-existing diabetes mellitus. Fourteen of the remaining forty-seven patients without pre-existing diabetes mellitus (29.8%) had newly diagnosed abnormal glucose metabolism. A further three patients (6.4%) had newly diagnosed diabetes mellitus. In our sample population approximately three patients were needed to screen for one new diagnosis of abnormal glucose metabolism and sixteen for one new diagnosis of diabetes to be made.

Conclusions: This audit demonstrated a higher prevalence of previously diagnosed and newly diagnosed diabetes in patients admitted with possible ACS than found in the general community. This reinforces the importance of comprehensive diabetes screening in this population.